The last decade has witnessed an explosion of interest in vitamin D. The vitamin has an established role in promoting bone health, but should we be routinely testing vitamin D levels in our patients? And what is the evidence that supplementation improves health beyond the skeleton?
Feeling good? Long-term conditions and psychological health
Compared with the rest of the population, people with long-term conditions—especially cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders—have two to three times the risk of experiencing a mental health problem. In this article we will consider how these issues affect long-term conditions, how we can assess their impact and how we can improve the psychological wellbeing of these patients.
The Eatwell Plate: Helping patients get the balance right
There are many fads about specific foods and their ‘super’ vitamins and minerals. Our choice of foods has also widened as supermarkets expand their ranges and previously specialist foods become mainstream. However, even though we can now buy tamarillos, Christmas-cake cheese or cranberry and pecan bread, the principle of proportion remains consistent. So the Eatwell Plate is very helpful in showing patients exactly what we mean when we advise them to follow a ‘healthy, balanced diet’.
Finding the right words to talk about weight
Excess body weight is associated with a higher risk of cardiovascular disease, type 2 diabetes, cancer and a range of other debilitating health conditions, and is the third leading cause of death in high-income countries like the UK. Since practice nurses may have long-term, regular contact with patients, they may be well placed to motivate and support individuals in losing weight. It can, however, be difficult for nurses to find the right words to discuss this very sensitive subject with patients.
NHS Health Check: A systematic approach to CVD prevention
The NHS Health Check offers 15 million people aged 40-74 years in England an assessment of cardiovascular risk, together with preventive interventions, once every five years. The programme has aroused some controversy, but there is an urgent need to take action now to reduce preventable, premature death and disability caused by vascular disease.
Using NOACs for stroke prevention in atrial fibrillation
Warfarin is highly effective in preventing strokes in people with atrial fibrillation (AF), but has its limitations. Only half of patients who could benefit actually receive warfarin, resulting in an estimated 7000 avoidable strokes each year.
Emergency! Recognising and treating anaphylaxis
A patient may present at any time suffering from the signs and symptoms of anaphylaxis, (a severe, life-threatening, generalised or systemic hypersensitivity reaction). This article explains how to recognise anaphylaxis and how to treat anaphylactic shock. It also outlines the responsibilities of practice nurses and other members of the primary healthcare team after a patient has had a suspected anaphylactic reaction.
Editorial
Well, how fast things change! The latest figures show that a massive proportion of practice nurses and nurse practitioners are going to retire in the next few years—me included, I guess. I am very aware that this exodus is already starting to have an impact on primary care, as I am receiving requests for advice from brand-new practice nurses, who may be established nurses but are not general-practice prepared. This is scaring me and should frighten everyone else.
Whatever has happened to QOF?
After several years of incremental adjustments and more new indicators, massive changes have been made to the new Quality and Outcomes Framework (QOF). So let us have a look at the facts and think about the implications of these changes for our daily routines from April.
How to eat well if your appetite is poor
www.leedscommunityhealthcare.nhs.uk
Food first: supporting adults with poor appetites
Malnutrition is a cause and consequence of disease, and affects at least 3 million adults in the UK, most of whom live in the community. By helping these vulnerable patients to eat the right types of food rather than use inappropriate supplements, practice nurses can not only help prevent and treat malnutrition, but also save the NHS millions of pounds each year.
Why and when to test for anaemia
In primary care, sending blood samples to the laboratory is so routine that it is easy to take these tests for granted. But it is important to understand the purpose of each test; when it is appropriate; and how to act on the results. Here red blood cell tests and their role in identifying possible causes for anaemia are discussed.
